Klymenko L. Changes of intracardiac haemodynamics, indices of myocardial ischemia, blood lipid spectrum and psychoemotional state in patients with ischemic heart disease combined with diabetes mellitus type 2 and their drug correction

The dissertation is devoted to reveal the features of changes of intracardiac haemodynamics, myocardial ischemia, blood lipid spectrum and psychoemotional state in patients with CAD combined with diabetes mellitus type 2 and their drug correction. The thesis is based on a comprehensive study of 172 patients with CAD, including 41 patients with ischemic heart disease combined with diabetes mellitus type 2, 32 patients with ischemic heart disease without diabetes mellitus type 2, 39 patients with CAD and postinfarction cardiosclerosis. The control group comprised 60 patients, comparable for age, sex and consominant pathology. It is shown that increased cardiac arrhythmias, autonomic nervous system imbalance in sympathetic toward increasing activity level and increasing rate in CAD patients, coupled with diabetes mellitus type 2 is increasing under the influence of anxiety disorders. Proved that diabetes mellitus type 2 raises CAD course, characterized by increasing signs of systolic, diastolic LV dysfunction, LV remodeling, however, no direct effect on anxiety indices of intracardiac haemodynamics. Studied the changes of blood lipid spectrum in patients with CAD and diabetes mellitus type 2 against a background of increasing performance anxiety. Determined impact of psychoemotional stress on HRV in patients with CAD and diabetes mellitus type 2, which is shown by increased activity level of sympathetic nervous system, cardiac rhythm, episodes segment depression ST, violation of systolic and diastolic LV function. The negative impact of psychoemotional stress on the course of these diseases is shown by increased number of patients with psychoemotional disorders, as evidenced by high levels of anxiety in patients. Grounded differentiated approach to treatment and proved the expediency of the appointment of anxiolytic for correction of psychoemotional state of patients with CAD and in combination with diabetes mellitus type 2.